Author: Viki Saidleman, RN MS
Title: Nursing Instructor
Institution: East Central University
1. Value the concept of EBP as integral to determining best clinical practice for older adults. (EBP-attitude)
2. Describe how the strength and relevance of evidence in Beers Criteria influences the choice of interventions in provision of patient-centered care. (EBP-knowledge) (Patient-centered care-skill)
3. Demonstrate effective use of strategies to reduce risk of medication related harm to older adults. (Safety-Skill)
5. Assert own position/perspective in discussions about patient care. (Teamwork & Collaboration-skill)
6. Appreciate importance of intra- and inter-professional collaboration. (Teamwork & Collaboration-skill)
This strategy can be used for either pre-licensure or RN to BSN students utilizing the clinical setting and either group or individual work in class, in post-clinical conference, or via online discussions or blogs. Prior to clinical, students are assigned the American Geriatric Society 2015 updated Beers Criteria for potentially inappropriate medication use for older adults link for review, the Hartford Geriatric Nursing Beers you-tube for viewing, and the ConsultGeri.org Try This Series site for regarding the Beers Criteria for reading. On the clinical day, a brief discussion can be held in pre-conference about Beers Criteria with a review of definitions for quality and strength of evidence and a brief account of methods used to analyze the evidence and to make recommendations. Students will be instructed to select an older adult patient over age 65 with 8 or more medications. In clinical, students are to record basic patient information like the client’s medical diagnoses, prescribed, routine, prn and over the counter medications as well as vitamin and mineral supplements. They will record these on the first section of the QSEN Beers Learning Strategy Form. After the clinical experience, students are instructed to complete the second section of the form requiring students to utilize the Beers Criteria to analyze the patient’s medications using the 5 tables in the Beers document to review the strength and quality of evidence, rationale, recommendations, safety concerns, risks, etc. The third part of the form includes questions about teamwork and collaboration interventions and appropriate patient centered interventions relevant for the completed evaluation of medications. This third part can be done in writing (individually or as a small group), on-line as part of a blog or discussion board or as part of a clinical post-conference session.
The strategy focuses on the application of evidence to practice in the geriatric setting regarding medication safety. Attention is given to quality and safety by focusing on risk reduction and prevention of medication related problems for the older adult vulnerable population. Patient centered care is addressed with individualized interventions based upon the medication evaluation using Beers Criteria. Students are asked to formulate teamwork and collaboration strategies to address medication concerns.
Evaluation will be based upon the following:
1) successful individual or group completion of the QSEN Beer’s Learning Strategy paper after clinical
2) successful after clinical written discussion, post-conference discussion or on-line blog or discussion
3) use of the Best Grading Rubric applied to the paperwork and discussion
4) student evaluation tool using a Likert scale